In surgery, in particular endoscopic surgery, flexible optical fibres are often used to deliver laser light from a laser device to a treatment site to ablate, cauterise, dissect, excise and/or resect hard or soft tissue. In use, the fibre is typically passed down an elongate channel in the probe until its distal delivery end projects out of the distal end of the elongate channel of the probe.
In some probes, typically in orthopaedic procedures, the laser beam preferably travels from the delivery end of the fibre substantially parallel to the longitudinal axis of a probe or channel, each of which is straight throughout its length. In other procedures, it is desirable to direct the exiting beam skewed to the axis of such a probe or channel, so that, for example soft, tissue which is alongside the probe can be treated.
Hitherto, the design of the latter type of probes has been dictated by the direction in which the exiting beam is required to travel respect to the elongate channel of the probe, and the desired direction of the exiting beam is not readily adjustable in such probes. Thus, a wide variety of probes has had to have been developed, each specific to a particular endoscopic surgical procedure and the desired direction of the exiting beam. This is a first technical problem over a large range of probes known in the art.
A similar second technical problem to that described above arises in multichannel endoscopic probes which comprise an elongate working channel for a variety of non-laser surgical equipment for ablating, dissecting, excising and/or resecting hard or soft tissue, where it is desired to illuminate the treatment site from various directions. This may be effected by for example using a flexible optical fibre in an auxiliary channel in the probe to deliver visible non-coherent light in a beam in the various directions, in particular in desired directions not specific to any one procedure.
Thus, it would be desirable to provide an endoscopic probe in which the delivery end of the fibre may be readily set at positions and configurations such that light which exits the fibre through its delivery end is in a desired direction. It would further be desirable to provide a versatile endoscopic probe which could provide an orientation of the delivery end required by a wide variety of procedures, so that a single probe may be used in such procedures.
Many endoscopic procedures, for example laser ablation of the prostate (LAP), such as holmium Laser Ablation of the Prostate (HoLAP) require any probe and elongate channel in the probe to be narrow.
The minimum dimension in the transverse direction of the elongate channel of the probe may typically be less than that of the space occupied by the distal delivery end of the fibre when deployed beyond the distal end of the channel and/or the probe, generally skewed to the longitudinal axis of the channel and/or the probe at their distal ends. This is a second technical problem which arises in providing a solution to the first technical problem.
Again, a similar second technical problem to that described above arises in multichannel endoscopic probes which comprise an elongate working channel for a variety of non-laser surgical equipment, where any such probe and any elongate channel in the probe are required to be narrow, but where it is desired to illuminate the treatment site from various directions. This may be effected by for example using a flexible optical fibre in a narrow auxiliary channel in the probe to deliver a visible non-coherent light beam in the various directions.
It will be seen that the second technical problem arises in providing a solution to the first technical problem for narrow probes
We have now found a solution which solves both the first and second technical problems.